Tension-Free Vaginal Tape for Stress Incontinence in Women

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Tension-Free Vaginal Tape for Stress Incontinence in Women

Surgery Overview

Stress incontinence in women can cause frequent involuntary release of urine during activities that put pressure on your bladder, such as coughing or laughing. The tension-free vaginal tape (TVT) procedure is designed to provide support for a sagging urethra so that when you cough or move vigorously or suddenly, the urethra can remain closed with no accidental release of urine.

In TVT surgery, a mesh tape is placed under your urethra like a sling or hammock to keep it in its normal position. The tape is inserted through tiny incisions in your abdomen and vaginal wall. No sutures are required to hold the tape in place. TVT surgery takes about 30 minutes and may be done under local anesthesia so you can cough at the surgeon's request to test the tape's support of your urethra.

Other sling surgeries are done in a way that is similar to TVT surgery. Transobturator tape (TOT) surgery is done almost as often as TVT in a slightly different way.

What To Expect After Surgery

Usually within hours of your surgery, you will be asked to urinate to test how your bladder and urethra respond to the surgery. You may be released to go home the same day as your surgery, or you may remain in the hospital overnight. It may be necessary to have a thin, flexible tube (catheter) placed into your bladder through your urethra to allow urine to drain while you recover or to teach you to do self-catheterization temporarily.

TVT surgery usually causes minimal pain and discomfort. Although you may resume most normal activities within 1 to 2 weeks, you will be advised to refrain from driving for 2 weeks and from sexual intercourse or strenuous activities for 6 weeks.

Recovery times for TOT surgery are similar to those for TVT surgery.

Why It Is Done

Tension-free vaginal tape is used to correct stress incontinence caused by sagging of the urethra. It is a relatively simple procedure that can be done with minimal hospitalization and recovery time.

How Well It Works

Tension-free vaginal tape surgery works as well as the Burch colposuspension surgery to cure stress incontinence. About 8 out of 10 women are cured ("dry") in the year after TVT surgery. Long-term success rates are not known.1

Surgery time, hospital stay, and recovery time are all shorter for women who have TVT compared to women who have retropubic suspension surgery.

By: Healthwise Staff
Medical Review: E. Gregory Thompson, MD - Internal Medicine
Avery L. Seifert, MD - Urology
Last Revised: September 13, 2010

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